Helping Parents of Special Needs Students Manage Their Stress: A SSWN Research Brief
Lindo, E. J., Kliemann, K. R., Combes, B. H., & Frank, J. (2016). Managing stress levels of parents of children with developmental disabilities: A meta‐analytic review of interventions. Family Relations, 65(1), 207-224.
Note: for this Research Brief (RB) we don’t have full-text open-access to this article. Anyone interested in finding the full-text of the article can use this link to ask the authors to share it directly with them (via the ResearchGate platform). If you want to discuss this study and the topic of supporting parents with students who have special needs, join us for our weekly LiveChat on SSWNetwork on Saturday, February 1st from 9-10 a.m. 100% free to join always, and we have almost 2,300 school clinicians there ready to collaborate with you.
To continue the discussion I started this week here and on SSWNetwork about providing supports to parents of children with special needs, I am sharing a summary of this article to help us identify interventions that work to help this special parent population.
What was the Study About?
In this meta-analytic review, the authors looked at types of interventions that were effective in reducing stress levels for parents of children with developmental disabilities. The authors looked at stress management interventions that targeted parents of children with moderate to severe developmental disabilities. The authors made the important distinction between children who have mild disabilities and how they differ in developmental needs/parental expectations across the lifespan to children who have more moderate to severe needs. The authors chose to focus on interventions that were implemented in North America and noted that there is much variability cross-culturally about what constitutes a disability. The authors also focused their criteria on interventions that addressed managing ongoing stress or chronic stress that is faced by parents of children with developmental disabilities. They differentiated these type of intervention programs from those that focused more on treating depression in parents. They also chose studies that had a comparison group.
The authors asked the following questions in their review: “What interventions have been effective in reducing the stress levels of parental caregivers of children with developmental disabilities? Are these effects moderated by treatment, parent, or child characteristics?”
What Did They Find?
A total of 6 studies met eligibility criteria for this review. The review included 410 parent participants, 250 in the treatment group and 160 in the control group. Most of the parents (over 78%) were mothers of students between the ages of 18 months to 16 years with a developmental disability. The disabilities included general developmental delay, autism, intellectual disability, and other. The authors categorized the types of interventions into two general categories. The first category was behavioral parent training (BPT) and the second was coping skills interventions (CSI). In BPT interventions, the focus was on teaching parents strategies that would improve the behavior of their children. Examples of skills taught included behavior analysis as well as strategies for reinforcing positive behaviors and extinguishing negative behaviors. In CSI type of interventions, the focus was on teaching the parents how to improve their ability to respond to the challenging behaviors of their children. Two specific interventions that were used included Acceptance and Commitment Therapy and Mindfulness Awareness for Parenting Stress.
Examples of skills taught in this type of intervention included coping skills such as mindfulness training, progressive muscle relaxation, self-monitoring, cognitive reframing, communication techniques, problem-solving strategies, decision making, and conflict-resolution.
Of the six studies, two examined the impact of BPT in a home setting and four studies examined the impact of CSI in a clinical setting. The BPT interventions were presented on an individual basis for 1-2 hours a week for between 12 and 32 weeks. The CSI intervention was a group intervention in a clinical setting. The average time was 2 hours long, 1-2 times per week for 5-8 weeks. Both types of interventions included providing ongoing support to parents. The outcome measures that were used in the studies included: Parenting Stress Index-short form in 3 studies, Questionnaire on Resources and Stress in 2 studies, and the State-Trait Anxiety Inventory in 1 study.
The authors found a positive effect on the reduction of parental stress with both types of interventions. The overall effect size for the home-based BPT interventions was 0.73. The authors reported that this positive effect could have been a result of the intervention taking place in the home as well as lasting longer. The overall effect size for the CSI interventions was 0.46. The authors stated the “findings suggest a moderate to large, and significant, effect of these stress management interventions.”
Despite limitations of the small sample size in this review, the information presented is very promising and encouraging for those mental health professionals that are interested in increasing supports and decreasing stress for parents of children with developmental disabilities.
Why Is The Study Important & What Can School Social Workers Do With This Information?
This is a major step forward in looking at what the evidence base is for helping parents, and is one of the first research syntheses on this topic. That being the case, as with all studies there were limitations. The authors acknowledged that the sample size in this review was small. They reported not having sufficient data to further analyze other factors such as the impact of participant characteristics or specific features of treatments. Examples of participant characteristics may include socio economic status, level of education, marital status, or mental health diagnoses. Examples of specific features of interventions can be intervention setting, duration, frequency, etc. Despite limitations of the small sample size in this review, the information presented is very promising and encouraging for those mental health professionals that are interested in increasing supports and decreasing stress for parents of children with developmental disabilities.